My Hero (Lexapro) is letting me down... What about a Lexapro cocktail?

[panicface]

10mg of Lexapro changed my life. Was able to get out and do stuff again without crippling anxiety.

After 2yr the anxiety started to slip back in. The first thing that shows up are ectopic heartbeats (heart skipping). Then waves of anxiety follow.

Doctor upped me to 15mg... Good to go, there were no more skipped beats, but more 'general' low level anxiety.

It's been 2 more years and now getting crippling anxiety. Like right now, I want to stop typing, get out of bed and walk 4 steps to my desk to take .5mg Xanax, but I am fearful I will die of heart attack if I stand up. Skipped beats about 20x a day.

I am fearful to go to 20mg as that's where (arguably) Lexapro stops being safe for consumption.

Should I take the plunge to 20mg and give it a month to kick in? (Can't ask my doctor as he's just a GP - and doesn't know crap about anything).. No psychiatrist around me.

Or is there a drug cocktail I could try - someone before mentioned adding a low dose of Buspar with my Lexapro to both stop sexual side effects and promote effectiveness.

Any other drug I could try along with my 15mg Lexapro to try to increase effectiveness, before I jump in the 20mg a day pool?

I'm a pro-pill splitter.. would a bump to 17.5mg be beneficial at all?

THANK YOU>>>>>>>

[NoraB]

10mg of Lexapro changed my life. Was able to get out and do stuff again without crippling anxiety.

After 2yr the anxiety started to slip back in. The first thing that shows up are ectopic heartbeats (heart skipping). Then waves of anxiety follow.

Doctor upped me to 15mg... Good to go, there were no more skipped beats, but more 'general' low level anxiety.

It's been 2 more years and now getting crippling anxiety. Like right now, I want to stop typing, get out of bed and walk 4 steps to my desk to take .5mg Xanax, but I am fearful I will die of heart attack if I stand up. Skipped beats about 20x a day.

I am fearful to go to 20mg as that's where (arguably) Lexapro stops being safe for consumption.

The problem with treating anxiety with drugs alone, is that the body gets used to the medication and we need more of it to get the same effects. (And there are safe limits with every drug)

Should I take the plunge to 20mg and give it a month to kick in? (Can't ask my doctor as he's just a GP - and doesn't know crap about anything).. No psychiatrist around me.

Any GP who can't advise you on medication has no business being a doctor.

Or is there a drug cocktail I could try - someone before mentioned adding a low dose of Buspar with my Lexapro to both stop sexual side effects and promote effectiveness.

We're not doctors. We don't have access to your medical notes or the years of training at med school. (Only one person can help you here, and that's your doctor)

The real 'hero' with anxiety is therapy because it's this which teaches us to challenge our thinking. Anyone can take a pill; all it requires is water and the ability to swallow. Voila, you can function again. Sorta. But your anxiety hasn't been addressed; it's being masked. It's still there and it keeps creeping up as the effectiveness of the medication declines. And this is what's happening to you.

My advice is to speak to your doctor re your medication and really give some thought to CBT..

[panicface]

The problem with treating anxiety with drugs alone, is that the body gets used to the medication and we need more of it to get the same effects. (And there are safe limits with every drug)



Any GP who can't advise you on medication has no business being a doctor.



We're not doctors. We don't have access to your medical notes or the years of training at med school. (Only one person can help you here, and that's your doctor)

The real 'hero' with anxiety is therapy because it's this which teaches us to challenge our thinking. Anyone can take a pill; all it requires is water and the ability to swallow. Voila, you can function again. Sorta. But your anxiety hasn't been addressed; it's being masked. It's still there and it keeps creeping up as the effectiveness of the medication declines. And this is what's happening to you.

My advice is to speak to your doctor re your medication and really give some thought to CBT..

Agree, you're not a doctor, but many of you have vast experience - the Homer Simpson Avatar and another guy in particular. Also, you guys have literally hundreds of years of combined experience.. It's not a crazy chance that a few of you had Lexapro poop-out and tried Buspar and it worked / didn't work.

Also, I would assume most of you are in the west someplace and have access to decent doctors and psychiatrists, thus can share that wisdom. There is such a thing as wisdom of crowds, if nothing else - just to point you to an avenue of research. How I found out about Lexapro 4 years ago was this forum!

Not sold on psychotherapy either, for everyone. I have nothing bad in my life, nor have I ever had anything, except a parent die 25+ years ago. My very first memory is staring out at the beach when I was 3 or 4 watching my mother go into the water and just feeling COMPLETE TERROR she would drown, something would eat her, she would be dead. I don't know many 4yo that are obsessed with death, but this extreme anxiety was there from the start and only grew worse.

Fear of trying new foods, going up, climbing steps, open spaces, patterns, starleling noises, fear of going insane or dropping over from heart attack. In high school I had multiple full blown panic attacks per day, every day, remember just sitting there in the school desk with my fingers on my jugular feeling my pulse, sleeping in a reclining lounge-chair at night full clothed cause sleeping in a bed was too corpse-like.

I have been to many therapists and psychologist when I lived in the west, I've done biofeedback,, we've plumbed the depths of my anxiety - and there's really no event that it sprang from. I't just an existential fear that comes out of no-where, and subtly changes each time. As an adult I have seen death up close and am not afraid of it - any more than the next person who doesn't want to experience it.

My point is - that even tho the new 'common wisdom' is that depression and anxiety are not 'chemical imbalances' like they told us in the 80's and 90's - for me at least, I think it is. I can be watching Breaking Bad (or more likely Love Island - groan), look down at my Apple Watch and see that my HR has climbed up to base rate of 95 and I'm going into a panic attack - why? I have no stress in my life. I have a great wife, am retired, well traveled, feel fulfilled, it's a BRAIN issue.

I take a Xanax and everything goes away, no fear of death, no anxiety, no doom cloud, no higher heart rate, palpitations, etc. Same with Lexapro when it works.. So advising everyone that psychotherapy is the answer - I don't really buy it. Some people are born with down syndrome, Huntingtons Korea, smaller amounts of frontal cortex, blind, etc - nature is imperfect, maybe my fight & flight mech is always on low drive.. Maybe people with panic have some physical issue.

Anyway, I live in far away Asia, there is nothing but GPs around me, and only one that speaks English well. There are no psychiatrists to speak of. I tell him what medicine I want and he writes the script, smiles and says good luck sir.

Peace.

[NoraB]

Agree, you're not a doctor, but many of you have vast experience - the Homer Simpson Avatar and another guy in particular. Also, you guys have literally hundreds of years of combined experience.. It's not a crazy chance that a few of you had Lexapro poop-out and tried Buspar and it worked / didn't work.

I've had anxiety (high as my norm) all my life, anxiety disorders, and a mental breakdown. I understand the importance of therapy and that's what I try to get across on here..

Not sold on psychotherapy either, for everyone. I have nothing bad in my life, nor have I ever had anything, except a parent die 25+ years ago.

That's literally one of the most stressful things that can happen to you..

My very first memory is staring out at the beach when I was 3 or 4 watching my mother go into the water and just feeling COMPLETE TERROR she would drown, something would eat her, she would be dead. I don't know many 4yo that are obsessed with death, but this extreme anxiety was there from the start and only grew worse.

I was the same. I was absolutely obsessed with death and dying, and from a very early age. I've had health anxiety for as long as I can remember (But it has been successfully controlled for the last few years)

Fear of trying new foods, going up, climbing steps, open spaces, patterns, starleling noises, fear of going insane or dropping over from heart attack. In high school I had multiple full blown panic attacks per day, every day, remember just sitting there in the school desk with my fingers on my jugular feeling my pulse, sleeping in a reclining lounge-chair at night full clothed cause sleeping in a lounge chair was too corpse-like.

You've pretty much described me here..

I have been to many therapists and psychologist when I lived in the west, I've done biofeedback,, we've plumbed the depths of my anxiety - and there's really no event that it sprang from. I't just an existential fear that comes out of no-where, and subtly changes each time. As an adult I have seen death up close and am not afraid of it - any more than the next person who doesn't want to experience it.

Understanding the root cause of an anxiety disorder is useful, but more important is to learn how to challenge your thoughts. No pill can do this for you. What medication can do is to lessen the symptoms of anxiety sufficiently to allow you to engage with therapy.

My point is - that even tho the new 'common wisdom' is that depression and anxiety are not 'chemical imbalances' like they told us in the 80's and 90's - for me at least, I think it is. I can be watching Breaking Bad (or more likely Love Island - groan), look down at my Apple Watch and see that my HR has climbed up to base rate of 95 and I'm going into a panic attack - why? I have no stress in my life. I have a great wife, am retired, well traveled, feel fulfilled, it's a BRAIN issue.

First thing I'd ask is why you are wearing one of these watches when you have HA? (Take it off, it's making things worse, trust me)

Secondly, I'd ask you to do your research on the stress response and understand how your thoughts will push the heart rate up. (And also, how you can bring it down by breathing properly)

I take a Xanax and everything goes away, no fear of death, no anxiety, no doom cloud, no higher heart rate, palpitations, etc.

And if you don't take the Xanax, fear kicks your @rse, right?

It doesn't go away.

These fears are masked by the medication. It's the stress hormones and physical symptoms which are being controlled by the meds, and the sedative effect in the drugs mean that you don't care.

So advising everyone that psychotherapy is the answer - I don't really buy it.

I'm advising you to speak to a doctor who can tweak your meds so that you are not adding to your problems. The more medication you take, the more side-effects you have to deal with. Before you know it, you're taking meds to counteract the side effects of other meds. But meds can be very helpful when used correctly. And I'm advising you that this, in combination with therapy, is what will help you to control this disorder, and not just mask the symptoms.

Some people are born with down syndrome, Huntingtons Korea, smaller amounts of frontal cortex, blind, etc - nature is imperfect, maybe my fight & flight mech is always on low drive.. Maybe people with panic have some physical issue.

I was born autistic. I have a neurological difference which makes me prepositioned to anxiety and depression. I don't know what it feels like to function without a high level of anxiety. Even so, I have been able to help myself and HA is one area where I've been successful. (And I did that by learning how to challenge my thoughts)

Anyway, I life in far away Asia, there is nothing but GPs around me, and only one that speaks English well. There are no psychiatrists to speak of. I tell him what medicine I want and he writes the script, smiles and says good luck sir.

I do understand. You just want to pop the pills and have this all go away. I did too until I realised that it wasn't an option (due to me developing chemical sensitivity).

I can also appreciate the obstacles that you're experiencing re where you live etc, but the truth is this; if you want out of this situation badly enough, you will find a way around these obstacles.

Regrettably, I can't help you anymore. You seem determined to take the pills and do nothing else, and that's your right, of course.

There will be others on here who can absolutely give you the advice that you want, so I'll move along and leave you all to it.

All the best to you.

[Catkins]

Medication isn't everything with regards to recovery. I do think it plays an important part for me, but I also thing the other things I do help as well. So that when I feel anxious I can cope with the anxiety symptoms so that they don't snowball. I've had years of counselling with regards to things that happened to me growing up and the emotional disfunction that they created in me. Does that mean it's not going to be effective for me anymore? No. I'm currently having person centred counselling which focuses a lot on mindful self compassion and changing my attitude to the way I see things and allowing myself to accept my feelings. It's not just going over the same old shit that I have before. I also do yoga, guided meditations and anything else that helps keep my anxiety levels more manageable. I've also had CBT which really helps. Am I 100% effectively managing my anxiety, no, I still have wobbles, but things are hell of a lot easier than they were.

Would you consider taking a different approach? Would you try different types of counselling, meditation, yoga, mindfulness etc?

[panicface]

Would you consider taking a different approach? Would you try different types of counselling, meditation, yoga, mindfulness etc?

Honestly, nope - not really open to any of those.

Like I said, I had almost 14 years of therapy and I found it less than useful. Parents first sent me to child psychologists who determined I was fine and parents had the problems. They didn't like that, so went to some kind of religious therapist who (when not falling asleep in session) told me that god and the devil were fighting over my soul (sigh). Many other psychiatrists most of whom wanted to put me on SERIOUS drugs - none of which really treat GAD, along with late night visits to ER for sustained HR of 171 etc - who wanted to pump me full of anti-stroke drugs as they thought I was doing coke.

I'm 50yo and have been dealing with this since I was like 5yo.. A lot has changed over the years - GAD and anxiety wasn't even a thing when I was in my teens and twenties (at least where I grew up).

I have a very easy life, I was in IT, had a business, 'retired' to Asia 15years ago at 35, have traveled extensively (120+ countries), and now just chill out and work on personal projects. I have literally zero stress in my life, there's no skeletons in the closet, there are no worries or fears. So I don't see how therapy can help me resolve painful issues that I have never had.... My childhood was good, great even (besides my anxiety). What is there to talk about?

Meditation - sure, I've done yoga, breathing, etc. It does temporarily relax me. Done biofeedback and that helps sometimes, as well as using mantras 'unpleasant but not unsafe'... I have weighted sleep blankets, get exercise, use aromatherapy, have my fave audiobooks (Harry Potter) that all calm me down. I do daily sessions in my sauna and cold dip.. But Anxiety attacks are just that 'attacks'.

It's like saying, do you want to take some therapy it will help prevent you walking down the street during the day and getting mugged and beaten by two dudes with masks..

Lexapro works wonders, it takes 90% of anxiety away... I don't feel it's making some underlying issue, I think it's relieving or shutting down something wrong in my system. My HRV will increase to nearly 100 sometimes when on it - or Xanax. this means it's stopping the fight/flight signals from being received.

Since not getting the help I wanted about drugs, I probably will:

1. Take L-Theanine 200 mg supplements. I've read about this, and when taken with something like Lexapro it seems to make it more effective.
2. If not working, I'll start a low dose of Buspar in tandem with the Lexapro - serotonin syndrome doesn't seem probable with this combination and it's suppose to boost effectiveness.
2. Finally, if neither work - I'll up my dose from 15mg to 17.5 or eventually 20mg... If I can kick that can 3yr down the road then I will.

Appreciate both your sharing your story and the feedback. I just don't think therapy does much (for me). If I had trauma, anger issues, negative things - I would be the first person in therapy to talk through it and see if I could relieve the initial issue instead of masking it.

When you have a tooth ache, you don't meditate or talk it out - you go and get a root canal to fix the physical issues.

[pulisa]

So what did the psychiatrists come up with re the need for "serious" drugs? What was the suggested diagnosis?

I presume you're talking about antipsychotics such as quetiapine or risperidone?

[panicface]

So what did the psychiatrists come up with re the need for "serious" drugs? What was the suggested diagnosis?

I presume you're talking about antipsychotics such as quetiapine or risperidone?

O man, this was back in the day.. Like 1990 - 95.. One wanted to put me on Lithium, and another on a similarly strong drug. Anti psychotics. I said no thanks. 30 years later I now understand I had 'panic disorder' from 14-27yo (more than 2 episodes of panic attack per week), and now just have GAD and agoraphobia... No other symptoms like depression, mania, paranoia, bipolar, etc.

If I had let them, they would've messed me up good.

Sadly, I didn't find Xanax until I was in my 30's... So I went through literally hundreds of panic attacks with nothing... Just breathing, laying down, walking around the city, and a few close friends I'd call to talk me down. It really was exhausting - as I'm sure many of you know. As this was pre-internet and I had no idea what was going on. Each time honestly thought I was about to go crazy or drop dead. My panic attacks could last for hours - as once started / and then declining - the fear of it coming back would bring on another one.

Also, had a tremendous fear of flying, guaranteed full blown panic attack at takeoff and at least once in air. Somehow managed to see 120+ countries - but I'm sure this took a toll on my body.

Xanax changed all that, When panic attack started it would quickly calm me down (just lay in dark for 20 min).. Or, even better, when I started to listen to my body, feel one coming - and then take half a pill and cut it off at knees. Also, being able to have a Xanax in my pocket at all time (don't think I've left the house without one for last 20+ years) - is a great form of safety.

Today, Apple Watch helps, as I can see my baseline (sleep) Heart Rate start to rise a day or two in advance.

Lexapro really is the bomb tho - I mean, no anxiety at all, ever (when it's working). Amazing to get to feel like a 'normal' when it's chugging along..

I mean such an amazing, life saving, life changing drug.... Can't even tell you.. Want to cry crocodile tears now that it's not working as well.

[pulisa]

Could it be that you are needing to take more alprazolam/xanax to get the desired effect? You appear to be very reliant on xanax. This could be about benzo usage/addiction not lexapro?

[NoraB]

Appreciate both your sharing your story and the feedback. I just don't think therapy does much (for me). If I had trauma, anger issues, negative things - I would be the first person in therapy to talk through it and see if I could relieve the initial issue instead of masking it.

Going with your comparison of a tooth ache. Pain causes anxiety (and vice-versa) and anxiety amplifies pain. By understanding anxiety and the stress response, we can reduce the amount of pain we're experiencing. Yes, we need to get the tooth yanked (or whatever) to fix the physical issue, but this isn't about a bad tooth, it's about the way you think.

I've already said that my brain is predisposed to anxiety and depression. I can say the same as you; it's my brain. And nothing short of medicating myself into being a zombie (or having a lobotomy) will change this. But in learning to challenge my thoughts and understand the role of fight and flight (and how I can actually control it), I have improved my situation. Not 'cured' but improved. That's what I mean when I use the word 'therapy', as in cognitive behavioural therapy. This isn't where you lie on a couch and talk about your childhood/ crap marriage or the teacher who bullied you in 1977. CBT is about working with your irrational thoughts, the thoughts which have you reaching for the Xanax. It's damage limitation. I can stop a panic attack before it takes hold now. And these buggers were seriously ruining my life a few years ago (I had them daily). I have had several health issues over the last few years, and I haven't gone back down that hole once. Medication didn't help me (it was the reverse). I've taken medication historically but that only ever dampened down the physical symptoms. (Maybe if I'd have learned how to challenge my thinking all those years ago, I'd have avoided the mental breakdown?)

Going by your first response to me..

I take a Xanax and everything goes away, no fear of death, no anxiety, no doom cloud, no higher heart rate, palpitations, etc.

Same with Lexapro when it works..

CBT can help you to deal with the fear of death, acceptance being the key to it all. A pill will help you short-term, and only with the physical symptoms. If you were to do the psychological work, you wouldn't need to rely as much on the meds, and eventually maybe not at all. Or, does that thought alone cause you anxiety?

You could have more control over your anxiety. I'm not talking about yoga, meditation, or weighted blankets here. Those are all useful, but it's not what I'm talking about. I'm talking about challenging your thoughts and understanding why your body responds the way it does (fight or flight) and creates all of those unpleasant symptoms which ramp up anxiety. (Once you see the whole picture, it's really quite simple)

I'll throw something else in here too that I'm seeing with you. Have you ever considered that you could be autistic?

As you say in your thread title, your 'hero' is letting you down. That's because the nature of medication is that the body gets used to it and stops being effective, so we need more and more to get the same effects. Then we have to start mixing them with other drugs to get the same effects. I've worked in the pharma industry and it's an eyeopener, believe me. The fewer drugs that you can get away with taking, the better.

I'll be the first to admit that some people will never be rid of their anxiety or depression. (I am one such person) but I feel that I have more control over the situation, now I understand how to challenge my irrational thinking. Hence, it's been more than worth the time and effort..

P.S, I'm 52 and Harry Potter is one of my favourites too.